tylenol?

bsyrn, ASN, RN · Sep 23, 2013

I'm not sure why a child would be responsible for any medication. At my camp the nurses are responsible for all meds. Nothing is administered unless it is in the original container with a written order.

CloudySue · Sep 23, 2013

Kids really don't come in asking for any med in particular. This is the usual dialogue, with very little deviation from the script:

"My ________ hurts."

"What does your mom give you at home for that?"

"I dunno."

"How about an Advil for that?"

"Whatever works."

{nurse hands camper stock med}

"Here you go."

"Kay. Thanks. Bye."

If a parent sends their child to camp, unless its specifically stated by parent that they may NOT have a particular OTC med, that child is covered by a doctor's standing order for everyone. So we can give whatever to whomever as needed. So we are acting more like moms/dads when we give out meds like Tylenol.

kimberlyconway · Oct 4, 2013

We dont give any meds without a doctors order. We have every campers doctor sign our standing orders. If it is not on there then our doc has to order it.

heatherj76 · Oct 10, 2013

From what I've seen, many places require all medications coming in to be in a prescription or original bottle and the parent signs it in with the camp nurse.

CampNurse1 · Oct 24, 2013

At our place they can only bring meds in original containers. Our parents and caregivers get a medication instruction sheet that says this. It also says our nurses must follow the prescription label, e.g., "Administer at HS." Mom will sometimes say at check-in, "But I want you to give it at noon." No can do. The label says HS, and that's a doctor's order. I then offer them the option of taking the med home or getting the doctor to call or fax the change in the next 24 hours, or they have to come pick up their camper. This has caused much angst at the check-in table! In a pinch I can call the doctor (I don't tell mom that), but since they are non-compliant with our policy, I put the burden on them.

This is a good example of deciding what battles to fight. My camp director is adamant about this policy! Now, I am good with administering many medications at a different time than ordered. My boss wants all doctors orders followed to the letter, which, really, is good practice. We had a couple of conversations about it. My pitch was that nurses need discretion within our scope of practice, that's why we call it practice. My CD sees it only in black and white. At the time I thought he was dangerously close to practicing nursing, which is a show-stopper for me. I decided I could live with it, since his stance is entirely defensible, my stance less so, at least from the liability point of view. This policy is etched in stone at our camp.

Informal medication policy is a huge red flag. Each state has rules for non-nurse administration. These rules all involve state-approved training. So, "a retired couple from FL," or the CD or other staff have no place in medication administration. At best it is poor practice, at worst a criminal act. It amazes me how many camps do not seem to be aware of this.

It is tantalizing for CDs to have informal or no policy. Nurses are expensive, if available at all. A seat-of-the-pants policy will serve for 10 or 20 years with no issues. When that rare adverse event occurs, the camp will find itself in a pretty indefensible position.

Unlabeled meds in a zip lock bag? A minor making a health care decision? You googled it, it probably is Tylenol. Call the camp doctor, get an order, and administer from a properly labeled stock drug. With a formal policy, mom would have been told at check-in to take the zip lock home.

To the original poster: Camp nursing is a specialty unlike any other, and I think you did the best you could. When in doubt at camp, fall back on your training. Medication policy that works in nursing school or the hospital will serve you well at camp. Right drug, right time, right dose, right route, right client, right documentation, right reason.